Special Issue "The Impact of the COVID-19 Emergency on the Quality of Life of the General Population"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Psychology".

Deadline for manuscript submissions: 20 December 2021.

Special Issue Editor

Prof. Dr. Michele Roccella
E-Mail Website
Guest Editor
Child Neuropsychiatry, Department of Psychological Sciences, Pedagogical and Education, University of Palermo, 90128 Palermo, Italy
Interests: neurodevelopmental disorders; encephalopathies; epilepsies; neuromuscular diseases; sleep disorders; rare genetic syndromes; neuropsychological disorders
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Special Issue Information

Dear Colleagues,

COVID-19 is a pandemic that has forced many states to declare restrictive measures in order to prevent its wider spread. These measures are necessary to protect the health of adults, children, and people with disabilities.

Long quarantine periods could cause an increase in anxiety crises, fear of contagion, and post-traumatic stress disorder (frustration, boredom, isolation, fear, insomnia, difficulty concentrating).

Post-traumatic stress disorder (PTSD) is a condition that can develop in subjects who have been or have witnessed a traumatic, catastrophic, or violent event, or who have become aware of a traumatic experience that happened to a loved one.

In fact, from current cases, it emerges that the prevalence of PTSD varies from 1% to 9% in the general population and can reach 50%–60% in subgroups of subjects exposed to traumas considered particularly serious. PTSD develops as a consequence of one or more physical or psychological traumatic events, such as exposure to natural disasters such as earthquakes, fires, floods, hurricanes, tsunamis; wars, torture, death threats; road accidents, robbery, air accidents; diseases with unfavorable prognoses; complicated or traumatic mourning; physical and sexual abuse and abuse during childhood; victimization and discrimination based on gender, sexual orientation, gender identity. It can also develop following changes in lifestyle habits caused by the COVID-19 epidemic.

We welcome manuscripts on the impact of the COVID-19 emergency on the quality of life of the general population, children, and people with disabilities.

We will be happy to review your contributions to our Special Issue in the Journal Clinical Medicine.

Dr. Michele Roccella
Guest Editor

Manuscript Submission Information

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Keywords

  • post-traumatic stress disorder (PTSD);
  • COVID-19 emergency;
  • disabilities
  • quality of life
  • stress disorder

Published Papers (48 papers)

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Article
Type D Personality and Stomatognathic System Disorders in Physiotherapy Students during the COVID-19 Pandemic
by , , , and
J. Clin. Med. 2021, 10(21), 4892; https://doi.org/10.3390/jcm10214892 (registering DOI) - 23 Oct 2021
Viewed by 200
Abstract
Background: A person’s response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) [...] Read more.
Background: A person’s response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) in physiotherapy students during the COVID-19 pandemic. Objective: The goal of the research was to assess the presence of type D personality in students with symptoms of stomatognathic system disorders. Material and Method: The research was carried out among 300 physiotherapy students. The data were collected using the form of the occurrence of symptoms of SS disorders developed for the purpose of the study and the standardized psychological DS14 questionnaire. Results: In a group of 300 students, the presence of type D personality was found in 160 people (53.3%). People with type D personality had symptoms of SS disorders more often than the group without stressful personality traits. There was a significant difference between the groups regarding all the examined symptoms. In the group of people with type D personality, the most frequently reported symptoms of SS disorders included: headache (51.3%), pain in the neck and shoulder girdle (43.1%), and teeth clenching (35.6%). As many as 70% of the respondents in the group with symptoms of SS disorders (P1) had type D personality, whereas in the asymptomatic group (P2) this result was 23.3%. There was a significant difference between the groups (p = 0.00). Statistically significantly higher values of both D personality dimensions were observed in women than in men with symptoms of SS disorders. In people reporting symptoms of SS disorders, higher average values were observed in both dimensions of type D personality. There were significant differences between the groups. Conclusion: type D personality may contribute to the development of symptoms of stomatognathic disorders. Full article
Article
High Rate of Elder Abuse in the Time of COVID-19—A Cross Sectional Study of Geriatric and Neurology Clinic Patients
J. Clin. Med. 2021, 10(19), 4532; https://doi.org/10.3390/jcm10194532 - 30 Sep 2021
Viewed by 303
Abstract
The ongoing COVID-19 pandemic is believed to have caused a sharp increase in the incidence of elder abuse (EA), including as a result of isolation, social distance combined with increased interpersonal stressors. Thus, the aim of this study is to determine the impact [...] Read more.
The ongoing COVID-19 pandemic is believed to have caused a sharp increase in the incidence of elder abuse (EA), including as a result of isolation, social distance combined with increased interpersonal stressors. Thus, the aim of this study is to determine the impact of the COVID-19 pandemic on the elder abuse rates and the characteristics of risk factors. A total of 347 patients hospitalized in the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz were selected as subjects for the analysis. The tools used in the study are: Authors-Designed Questionnaire, the Vulnerability to Abuse Screening Scale, the Geriatric Depression Scale and the Activities of Daily Living Scale. Descriptive statistics, chi-squared tests, Spearman’s rank correlation test, and logistic regression analyses were used. In the studied population, nearly 45% of the elderly were victims of violence. This represents an increase of more than 6 percent compared to the pre-pandemic. The most common type of EA was psychological abuse (72.3%). In the final models, the risk factors include, among others, low income (OR = 3.60, 95% CI = 1.93–6.72), chronic diseases (OR = 2.06, 95% CI = 1.28–3.31), poor relationship with the family (OR = 3.26, 95% CI = 1.96–5.43), and moderate and severe depression (OR = 18.29, 95% CI = 10.24–32.69; OR = 18.49, 95% CI = 3.91–87.30, respectively). Moreover, moderate functional impairment 5.52 times more often and severe functional impairment 21.07 times more likely to predispose to EA. People who suffered from COVID-19 are 1.59 times more likely to be victims of EA (95% CI = 1.03–2.46). In this study, we saw significant increases in EA rates during the COVID-19 pandemic. Full article
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Article
Impact on the Mental and Physical Health of the Portuguese Population during the COVID-19 Confinement
J. Clin. Med. 2021, 10(19), 4464; https://doi.org/10.3390/jcm10194464 - 28 Sep 2021
Viewed by 335
Abstract
Confinement of the population has been one of the measures implemented by different governments to address the COVID-19 health crisis, and it has led to social isolation together with a disruption of daily activities. The aim of the study is to analyze psychological [...] Read more.
Confinement of the population has been one of the measures implemented by different governments to address the COVID-19 health crisis, and it has led to social isolation together with a disruption of daily activities. The aim of the study is to analyze psychological distress during the COVID-19 pandemic in Portugal. During the quarantine, a cross-sectional study was carried out on a sample of 2120 subjects over 18 years of age, resident and born in Portugal. Data were collected using a self-developed questionnaire that considered socio-demographic variables, physical symptoms, health conditions, and history of contact with COVID-19, as well as psychological alterations. The General Health Questionnaire (GHQ-12) was also included. Univariate and bivariate statistical analyses were performed. Predictive capacity was studied using logistic regression models. The results showed a higher percentage of individuals presenting psychological distress (57.2.0%), with a higher percentage identified among women (79.0%), and in people with a higher educational level (bachelor’s + master’s and doctorate) (75.8%). The predictor variables with the greatest weight were sex, educational level (graduation, master’s, and doctorate), living with children or under 16 years of age, presence of symptoms, and quarantine in the last 14 days for having symptoms. Good self-assessment of health and working at home appear to be protective against psychological distress. These results highlight the impact of the COVID-19 pandemic on psychological distress and provide an opportunity to consider the need to implement specific multidisciplinary public health and mental health interventions in this pandemic situation. Full article
Article
Burden of COVID-19 Pandemic Perceived by Polish Patients with Multiple Sclerosis
J. Clin. Med. 2021, 10(18), 4215; https://doi.org/10.3390/jcm10184215 - 17 Sep 2021
Viewed by 460
Abstract
People with multiple sclerosis (MS) were expected to be particularly affected by the COVID-19 pandemic. The purpose of the study was to evaluate the burden of pandemic, perceived by Polish MS patients, with regard to major contributing factors. The survey, conducted in August/September [...] Read more.
People with multiple sclerosis (MS) were expected to be particularly affected by the COVID-19 pandemic. The purpose of the study was to evaluate the burden of pandemic, perceived by Polish MS patients, with regard to major contributing factors. The survey, conducted in August/September 2020, included: Perceived Stress Scale (PSS-10), Coping Orientations to Problems Experienced (Brief–COPE), questions on demographic data, MS characteristics, and health-related and social aspects of pandemic burden. Relationships were searched between PSS-10 and Mini-COPE results and other analyzed items, using U Mann–Whitney test, Kruskal–Wallis ANOVA rank test and Spearman rank correlation. The survey was answered by 287 MS patients (208 female, 79 male, aged 21–69 years). Since March 2020, 2.4% of respondents had been positive for COVID-19 and 5.2% had undergone a quarantine. Mean PSS-10 score was 19.99, with moderate or high level of stress in 83.3% of respondents. Problem-focused strategies were more frequently used than emotion-focused strategies (1.76 vs. 1.16). Higher PSS-10 score was associated with comorbidities (H = 4.28), increase in major MS symptoms during the pandemic (21.92 vs. 18.06), experience of healthcare limitations (21.12 vs. 17.98), work-related (22.58 vs. 18.69), financial (22.70 vs. 18.83) and family-related problems (22.54 vs. 17.73) due to pandemic restrictions. A coping model was associated with functional disability and limitations to daily activities (H = 7.81). During the first stage of the pandemic, MS patients reported increased level of stress and preferred problem-focused coping. The level of stress and coping showed more relationships with pandemic impact upon social issues than with MS-related variables. Full article
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Article
Parental Distress and Perception of Children’s Executive Functioning after the First COVID-19 Lockdown in Italy
J. Clin. Med. 2021, 10(18), 4170; https://doi.org/10.3390/jcm10184170 - 15 Sep 2021
Viewed by 342
Abstract
The spread of the novel coronavirus (COVID-19), and the consequential first italian lockdown to minimize viral transmission, have resulted in many significant changes in the every-day lives of families, with an increased risk of parental burnout. This study explores the impact of the [...] Read more.
The spread of the novel coronavirus (COVID-19), and the consequential first italian lockdown to minimize viral transmission, have resulted in many significant changes in the every-day lives of families, with an increased risk of parental burnout. This study explores the impact of the first COVID-19 lockdown in Italy on parental distress and parental perceptions of children’s executive functions (EFs). Participants were 308 Italian parents with children between 4 and 17 years of age; they were recruited through online advertisements on websites and social media, and they were given an online survey. The measures were: the balance between risks and resources (BR2) and the executive functioning self-report (EF). Findings of the study suggest that the most distressed parents perceived their children as less competent in EF, highlighting a cognitive fragility on attention, memory, and self-regulation (Pearson correlation coefficient, p < 0.05); significant differences were found between parents of children exhibiting typical and atypical patterns of development (ANOVA, p < 0.05). The study reinforces the need to provide families with psychological aid to support parental competence in restrictive lockdown conditions. Full article
Article
The Impact of the COVID-19 Emergency on Life Activities and Delivery of Healthcare Services in the Elderly Population
J. Clin. Med. 2021, 10(18), 4089; https://doi.org/10.3390/jcm10184089 - 10 Sep 2021
Viewed by 529
Abstract
Due to the prevailing pandemic of the coronavirus disease COVID-19, we are experiencing emotional and social isolation, which negatively affects mental and physical health, particularly among the elderly population. In this study, we performed a cross-sectional analysis based on computer-assisted telephone interviews of [...] Read more.
Due to the prevailing pandemic of the coronavirus disease COVID-19, we are experiencing emotional and social isolation, which negatively affects mental and physical health, particularly among the elderly population. In this study, we performed a cross-sectional analysis based on computer-assisted telephone interviews of 500 Polish adults aged 60 years or older in order to determine the impact of the SARS-CoV-2 pandemic on the older population’s behavior, life activity, and delivery of healthcare services. According to our study, COVID-19 infection entailed a substantial change in older people’s behavior. Over 50%, nearly 80%, and more than 25% of the surveyed participants reduced their social, recreational, and professional activities, respectively. The most significant change in senior’s behavior due to the fear of COVID-19 infection was observed in patients (1) with cardiac and pulmonary problems, (2) being on multi-drug therapy, (3) vaccinated against influenza, and (4) with several mental difficulties including loneliness, social isolation, and depression. Furthermore, we demonstrated that 10% of participants canceled planned hospitalization due to the fear of COVID-19 infection. This was observed primarily in patients suffering from chronic heart and lung diseases, vaccinated against influenza, exhibiting the reluctance to carry out more complex daily activities, and with a higher level of anxiety, social loneliness, and malnutrition. Thus, these groups of seniors require more attention; hence, we propose telemedicine as a strategy directed to them that provides clinical healthcare and information regarding measurements, control, and protection against SARS-CoV-2 during the prevailing COVID-19 pandemic. We believe this strategy may improve treatment outcomes, reduce comorbidities-related complications and unnecessary hospitalizations. Full article
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Article
Changes in Stress, Coping Styles, and Life Satisfaction between the First and Second Waves of the COVID-19 Pandemic: A Longitudinal Cross-Lagged Study in a Sample of University Students
J. Clin. Med. 2021, 10(17), 4025; https://doi.org/10.3390/jcm10174025 - 06 Sep 2021
Viewed by 534
Abstract
In this study, we aimed to explain the interplay mechanism between stress, life satisfaction, and coping styles among university students. A cohort study was performed during the first (wave 1; W1) and second (wave 2; W2) waves of the Coronavirus disease 2019 (COVID-19) [...] Read more.
In this study, we aimed to explain the interplay mechanism between stress, life satisfaction, and coping styles among university students. A cohort study was performed during the first (wave 1; W1) and second (wave 2; W2) waves of the Coronavirus disease 2019 (COVID-19) pandemic. The total sample included 231 university students, of which 59.31% were women. The Satisfaction with Life Scale (SWLS), Perceived Stress Scale (PSS), and Coping Inventory for Stressful Situations (CISS) were included in one online survey. Stress, emotion-oriented, and avoidance-oriented coping styles increased from W1 to W2 of the COVID-19 pandemic, while life satisfaction and task-oriented coping decreased. The partial mediation effect of all three coping styles during W1 and W2 (in a cross-sectional approach) on the relationship between perceived stress and life satisfaction was confirmed in this study. The task-oriented and avoidance-oriented coping styles can play a mediating role in the reciprocal relationship between life satisfaction and perceived stress during W1 and W2 of the pandemic. There were no mutual interactions between stress and life satisfaction from a longitudinal approach. Coping styles changed subsequently due to stressful environmental changes related to lockdown during the COVID-19 pandemic. Having a wide range of coping strategies from which to choose during an unstable situation should help manage stress and well-being. Full article
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Article
Assessment of Anxiety, Depression, Attitude, and Coping Strategies of the Egyptian Population during the COVID-19 Pandemic
J. Clin. Med. 2021, 10(17), 3989; https://doi.org/10.3390/jcm10173989 - 03 Sep 2021
Cited by 1 | Viewed by 372
Abstract
Background: The COVID-19 pandemic has imposed several challenges on different populations all around the world, with stress being identified as one of the major challenges. This study aims to investigate the impact of COVID-19-induced stress on the prevalence and severity of anxiety and/or [...] Read more.
Background: The COVID-19 pandemic has imposed several challenges on different populations all around the world, with stress being identified as one of the major challenges. This study aims to investigate the impact of COVID-19-induced stress on the prevalence and severity of anxiety and/or depression, factors that predict the development of anxiety and/or depression, and coping strategies in the Egyptian population during the COVID 19 outbreak. Subjects and Methods: This is an observational cross-sectional online study. The questionnaire of our study included five sections: demographic and clinical data, attitude towards COVID-19, the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), and a specifically prepared and standardized Arabic version of a coping strategies scale. The questionnaire was uploaded on 20 May 2020 at 1 p.m. and closed on 7 July 2020 at 8 a.m. Results: The study questionnaire was completed by 283 Egyptians, with mean age 34.81 ± 11.36 years, of which 17% had been infected with COVID-19. The responses showed that 62.9% had moderate anxiety, whereas 12.4% had severe anxiety. Moreover, 13.8% had moderate depression, and 14.1% had severe depression. Our study demonstrated that age, mental status, and being infected with COVID-19 correlated with depression, whereas only age correlated with anxiety. Interestingly, our data showed that anxiety and depression were negatively correlated with some coping strategies during the COVID-19 pandemic. Conclusions: Pandemics, such as the COVID-19 pandemic, imposes stress on individuals, which leads to the development of anxiety and/or depression. Several factors, which could be population-dependent, may help predict the development of anxiety or depression. We show the factors correlated with depression and anxiety during the COVID-19 pandemic in the Egyptian population. Furthermore, certain personal coping strategies during the COVID-19 pandemic are negatively correlated with anxiety and depression. Therefore, our study sheds light on the importance of studying factors in each population that can lead to pandemic-induced psychological complications and those that can relieve such complications. Full article
Article
A Standardized Prospective Memory Evaluation of the Effects of COVID-19 Confinement on Young Students
J. Clin. Med. 2021, 10(17), 3919; https://doi.org/10.3390/jcm10173919 - 30 Aug 2021
Viewed by 531
Abstract
The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory [...] Read more.
The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory (PM), which are pivotal for the ability to plan and perform future activities. Although the number of studies documenting the COVID-19 effects has recently blossomed, most of them employed self-reported questionnaires as the assessment method. The main aim of our study was to use standardized tests to evaluate WM and PM in a population of young students. A sample of 150 female psychology students was recruited online for the administration of two self-reported questionnaires that investigated psychological wellbeing (DASS-21), prospective, and retrospective memory (PRMQ). Subjects were also administered two standardized tests for WM (PASAT) and PM (MIST). We found increased anxiety, depression, and stress and decreased PM as measured by self-reports. The perceived memory failures agreed with the results from the standardized tests, which demonstrated a decrease in both WM and PM. Thus, COVID-19 restriction has strongly impacted on students’ mental health and memory abilities, leaving an urgent need for psychological and cognitive recovery plans. Full article
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Article
The Influence of the COVID-19 Pandemic on the Stress Levels and Occurrence of Stomatoghnatic System Disorders (SSDs) among Physiotherapy Students in Poland
J. Clin. Med. 2021, 10(17), 3872; https://doi.org/10.3390/jcm10173872 - 28 Aug 2021
Cited by 1 | Viewed by 399
Abstract
Background: This study is a quantitative analysis examining the impact of the COVID-19 pandemic on the occurrence of stress and stomatognathic system disorders (SSDs) among students of physiotherapy. Objective: To assess stress severity, strategies of coping with stress and the presence of type [...] Read more.
Background: This study is a quantitative analysis examining the impact of the COVID-19 pandemic on the occurrence of stress and stomatognathic system disorders (SSDs) among students of physiotherapy. Objective: To assess stress severity, strategies of coping with stress and the presence of type D personality among physiotherapy students including those with symptoms of stomatognathic system disorders. Material and Methods: The research was conducted from October to December 2020 on a sample of 188 students of physiotherapy. The data were collected using a survey form related to the occurrence of SS disorders symptoms and standardized psychological questionnaires, such as the Perceived Stress Scale (PSS)-10, Mini-Cope, and the type-D Scale (DS14), developed for the purpose of this study. Results: Women experiencing at least one of the SS disorder-related symptoms were characterized by a significantly higher level of stress and a type D personality (p < 0.05). Among men, these differences were not statistically significant (p > 0.05). On the basis of the strategies of coping with stress, i.e., positive self-reevaluation, discharging and blaming oneself, and taking psychoactive substances, it is possible to predict the intensity of stress during the pandemic in the group of the examined students. Among the reported symptoms of SS, headache was a significant predictor of stress, which was accompanied by an increase in the intensity of stress by nearly 0.2 measurement points. Students with higher levels of stress showed more symptoms of type D personality, and those with more severe symptoms of SS showed higher levels of stress. Conclusions: People prone to stress and having type D personality traits should be assessed for the presence of SS disorders. Full article
Article
The Assessment of the Severity of COVID-19-Related Anxiety Symptoms in Participants of the University of the Third Age in Poland: A Cross-Sectional Study among Internet Survey Respondents
J. Clin. Med. 2021, 10(17), 3862; https://doi.org/10.3390/jcm10173862 - 27 Aug 2021
Cited by 1 | Viewed by 369
Abstract
Introduction: Fear of infection with SARS-CoV-2 has become widespread. All over the world, since the very beginning of the pandemic, older adults have been considered one of the groups at highest risk of SARS-CoV-2 infection and death due to COVID-19. The aim of [...] Read more.
Introduction: Fear of infection with SARS-CoV-2 has become widespread. All over the world, since the very beginning of the pandemic, older adults have been considered one of the groups at highest risk of SARS-CoV-2 infection and death due to COVID-19. The aim of the study was to evaluate the severity of anxiety symptoms related to COVID-19 in the older adults who are participants of the Universities of the Third Age in Poland. Material and methods: The study included participants of the University of the Third Age in Poland. A total of 296 persons were enrolled, including 258 women and 38 men. The study was a diagnostic survey, conducted with the use of the following validated psychometric scales: General Anxiety Disorder-7 (GAD-7), Short Health Anxiety Inventory (SHAI), and State-Trait Anxiety Inventory (STAI). Results: In two scales (STAI and SHAI), the mean scores demonstrated mild symptoms indicative of anxiety disorders in the older respondents. Women and men did differ significantly in terms of the scores obtained in STAI X-1 and STAI X-2. Single respondents differed significantly from divorced ones in terms of STAI X-1 scores. Moreover, widows/widowers differed significantly from divorced ones in terms of STAI X-2, and GAD-7 scores. Respondents declaring their financial status as average differed significantly from those declaring their financial status as good in terms of: STAI X-1, STAI X-2, SHAI, and GAD-7 scores. Conclusions: The subjective experience of anxiety symptoms associated with fear of contracting COVID-19 was increased due to the ongoing pandemic, but was not significantly high in the analysed population of older people. COVID-19-related anxiety was significantly more common in lonely individuals and in those of worse financial status. Women and men differed significantly in terms of perceived state anxiety and trait anxiety measured by STAI. More studies addressing COVID-19-related anxiety in older people participating in the Polish Universities of the Third Age are needed to determine a more accurate distribution of this phenomenon in Poland. Full article
Article
Do Mental Health and Vitality Mediate the Relationship between Perceived Control over Time and Fear of COVID-19? A Survey in an Italian Sample
J. Clin. Med. 2021, 10(16), 3516; https://doi.org/10.3390/jcm10163516 - 10 Aug 2021
Cited by 1 | Viewed by 400
Abstract
Several studies evidenced increased elevated symptomatology levels in anxiety, general stress, depression, and post-traumatic stress related to COVID-19. Real difficulties in the effective control of time that could be responsible for mental health issues and loss of vitality were also reported. Prior literature [...] Read more.
Several studies evidenced increased elevated symptomatology levels in anxiety, general stress, depression, and post-traumatic stress related to COVID-19. Real difficulties in the effective control of time that could be responsible for mental health issues and loss of vitality were also reported. Prior literature highlighted how perceived control over time significantly modulates anxiety disorders and promotes psychological well-being. To verify the hypothesis that perceived control over time predicts fear of COVID-19 and mental health and vitality mediate this relationship, we performed an online survey on a sample of 301 subjects (female = 68%; Mage = 22.12, SD = 6.29; age range = 18–57 years), testing a parallel mediation model using PROCESS macro (model 4). All participants responded to self-report measures of perceived control over time, COVID-19 fear, mental health, and vitality subscales of the Short-Form-36 Health Survey. Results corroborate the hypotheses of direct relationships between all the study variables and partially validate the mediation’s indirect effect. Indeed, mental health (a1b1 = −0.06; CI: LL = −0.11; UL = −0.01; p < 0.001) rather than vitality (a2b2 = −0.06; CI: LL = −0.09; UL = 0.03; n.s.) emerges as a significant mediator between perceived control over time and fear of COVID-19. Practical implications of the study about treatment programs based on perceived control over time and emotional coping to prevent fear and anxiety toward the COVID-19 pandemic are discussed. Full article
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Article
The Quality of Medical Care in the Conditions of the COVID-19 Pandemic, with Particular Emphasis on the Access to Primary Healthcare and the Effectiveness of Treatment in Poland
J. Clin. Med. 2021, 10(16), 3502; https://doi.org/10.3390/jcm10163502 - 09 Aug 2021
Viewed by 451
Abstract
Health has a significant influence on the quality of life of a society. The COVID-19 pandemic has forced many countries to implement restrictive measures to prevent its wider spread, including, inter alia, the introduction of remote healthcare in the form of teleconsultations. Therefore, [...] Read more.
Health has a significant influence on the quality of life of a society. The COVID-19 pandemic has forced many countries to implement restrictive measures to prevent its wider spread, including, inter alia, the introduction of remote healthcare in the form of teleconsultations. Therefore, there is the question of how such a change affects the quality of treatment and the primary healthcare of patients during the COVID-19 pandemic. The article aims to examine patient satisfaction with the access to primary healthcare and the effectiveness of treatment in a condition of remote medical care caused by the COVID-19 pandemic. We also analyse the impact of access to primary healthcare on the treatment effectiveness. Patient satisfaction was measured using a questionnaire assessing the quality of primary medical care. Of the 36 items studied, seven were related to the accessibility dimension and four were related to the treatment effectiveness dimension. Our results suggest that the treatment effectiveness and the access to primary healthcare services during the COVID-19 pandemic through telemedicine are quite highly rated by patients. Hence, further implementation of telemedicine in primary healthcare should improve the quality of lives of the wide society. We have also identified the access to primary healthcare has a considerable impact on the treatment effectiveness. Therefore, we recommend increasing the contact between patients and GPs via telemedicine under lockdown conditions. Full article
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Article
A Comparison of Depression and Anxiety among University Students in Nine Countries during the COVID-19 Pandemic
J. Clin. Med. 2021, 10(13), 2882; https://doi.org/10.3390/jcm10132882 - 29 Jun 2021
Cited by 2 | Viewed by 1062
Abstract
The mental health of young adults, particularly students, is at high risk during the COVID-19 pandemic. The purpose of this study was to examine differences in mental health between university students in nine countries during the pandemic. The study encompassed 2349 university students [...] Read more.
The mental health of young adults, particularly students, is at high risk during the COVID-19 pandemic. The purpose of this study was to examine differences in mental health between university students in nine countries during the pandemic. The study encompassed 2349 university students (69% female) from Colombia, the Czech Republic (Czechia), Germany, Israel, Poland, Russia, Slovenia, Turkey, and Ukraine. Participants underwent the following tests: Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7), Exposure to COVID-19 (EC-19), Perceived Impact of Coronavirus (PIC) on students’ well-being, Physical Activity (PA), and General Self-Reported Health (GSRH). The one-way ANOVA showed significant differences between countries. The highest depression and anxiety risk occurred in Turkey, the lowest depression in the Czech Republic and the lowest anxiety in Germany. The χ2 independence test showed that EC-19, PIC, and GSRH were associated with anxiety and depression in most of the countries, whereas PA was associated in less than half of the countries. Logistic regression showed distinct risk factors for each country. Gender and EC-19 were the most frequent predictors of depression and anxiety across the countries. The role of gender and PA for depression and anxiety is not universal and depends on cross-cultural differences. Students’ mental health should be addressed from a cross-cultural perspective. Full article
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Article
Coping Strategies by University Students in Response to COVID-19: Differences between Community and Clinical Groups
J. Clin. Med. 2021, 10(11), 2499; https://doi.org/10.3390/jcm10112499 - 05 Jun 2021
Viewed by 646
Abstract
Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens’ mental health. This research analyses the coping [...] Read more.
Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens’ mental health. This research analyses the coping strategies generated by students from a community group and a clinical group in response to this crisis, using the Coping Responses Inventory—Adult Form (CRI-A) by Moos with a sample of 1074 students of Universidad de Extremadura. Multivariate analysis and receiver operating characteristic curve analysis have been carried out, revealing, amongst other things, a greater predisposition of the clinical sample towards factors such as seeking guidance and support, cognitive avoidance or emotional discharge. Results show that students with prior mental health problems perform an unhealthy coping response based on avoidance strategies. This group of students suffers a double source of distress and anxiety, one derived from their prior psychopathologic problems and the stress of the lockdown and another one originating from an inefficient coping response, which makes coping strategies raise levels of distress and anxiety. Full article
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Article
The Relationship between Fear of Infection and Insomnia among Dentists from Oradea Metropolitan Area during the Outbreak of Sars-CoV-2 Pandemic
J. Clin. Med. 2021, 10(11), 2494; https://doi.org/10.3390/jcm10112494 - 04 Jun 2021
Viewed by 445
Abstract
Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of [...] Read more.
Various studies have shown the impact of COVID-19 pandemic on mental health, identifying that people with a strong fear of getting infected are more prone to become stressed, depressed, anxious and to experience sleeping disturbance. The present study focuses on the impact of fear of COVID-19 and its relationship with insomnia among dentists. 83 dentists from public and private clinics were included in the research. A questionnaire was especially constructed for this study, consisting of three parts: the first part gathered socio-demographic and medical data, and a succession of self-rated items collected opinions about lockdown and preventive behaviors; the second part evaluated the level of fear of infection with Coronavirus-19 using the Fear of Covid 19 Scale; the third part investigated the presence of insomnia using the Athens Insomnia Scale. Collected data were processed using SPSS (v. 25). The total scores for fear of COVID 19 and insomnia were assessed. A strong positive correlation was identified between the total score of AIS and the total score of FCV-19S. The fear of COVID-19 had a significant positive correlation with the practice of several preventive behaviors. Dentists with chronic diseases were found to be more prone to suffer from insomnia than healthy dentists. Significant differences between women and men in terms of night symptoms were discussed. The findings are useful for dentists and policy makers to evaluate the impact of fear of infection on mental health status. Full article
Article
A Well-Structured Follow-Up Program is Required after Recovery from Coronavirus Disease 2019 (COVID-19); Release from Quarantine is Not the End of Treatment
J. Clin. Med. 2021, 10(11), 2329; https://doi.org/10.3390/jcm10112329 - 26 May 2021
Viewed by 748
Abstract
During the Coronavirus Infection Disease-19 (COVID-19) pandemic, the number of patients released from quarantine is exceeding the number of newly diagnosed cases. This study is a retrospective cohort study in which consultation data were collected from a COVID-19 follow-up health consultation program. The [...] Read more.
During the Coronavirus Infection Disease-19 (COVID-19) pandemic, the number of patients released from quarantine is exceeding the number of newly diagnosed cases. This study is a retrospective cohort study in which consultation data were collected from a COVID-19 follow-up health consultation program. The studied population was selected from patients who recovered after quarantine and treatment for COVID-19 in Daegu City and in Gyeongsangbukdo province, Korea, from March to June 2020. The healthcare providers comprised 20 family-medicine specialists who consulted and educated the patients through phone calls in accordance with structured guidelines. Physical and mental status before and after recovery were compared among patients who received a single consultation and those who received two or more consultations. A total of 1604 subjects were selected for the final analysis. Of these, 1145 (71.4%) had one consultation and 459 (28.6%) had two or more. The group that had two or more consultations reported significantly more physical symptoms, more psychological symptoms (including depression), and more psychological stress. Multivariate forward selection logistic regression analysis showed that re-confirmed cases of COVID-19, physical symptoms after quarantine, feelings of depression, and psychological stress had a significant effect on the number of consultations received. In conclusion, COVID-19 has various physical and mental sequelae after discharge from quarantine. Therefore, a well-structured follow-up program is needed after recovery. Full article
Article
Cardiovascular and Pre-Frailty Risk Assessment during Shelter-In-Place Measures Based on Multimodal Biomarkers Collected from Smart Telemedical Wearables
J. Clin. Med. 2021, 10(9), 1997; https://doi.org/10.3390/jcm10091997 - 06 May 2021
Viewed by 623
Abstract
Wearable devices play a growing role in healthcare applications and disease prevention. We conducted a retrospective study to assess cardiovascular and pre-frailty risk during the Covid-19 shelter-in-place measures on human activity patterns based on multimodal biomarkers collected from smartwatch sensors. For methodology validation [...] Read more.
Wearable devices play a growing role in healthcare applications and disease prevention. We conducted a retrospective study to assess cardiovascular and pre-frailty risk during the Covid-19 shelter-in-place measures on human activity patterns based on multimodal biomarkers collected from smartwatch sensors. For methodology validation we enrolled five adult participants (age range: 32 to 84 years; mean 57 ± 22.38; BMI: 27.80 ± 2.95 kg/m2) categorized by age who were smartwatch users and self-isolating at home during the Covid-19 pandemic. Resting heart rate, daily steps, and minutes asleep were recorded using smartwatch sensors. Overall, we created a dataset of 464 days of continuous measurement that included 50 days of self-isolation at home during the Covid-19 pandemic. Student’s t-test was used to determine significant differences between the pre-Covid-19 and Covid-19 periods. Our findings suggest that there was a significant decrease in the number of daily steps (−57.21%; −4321; 95% CI, 3722 to 4920) and resting heart rate (−4.81%; −3.04; 95% CI, 2.59 to 3.51) during the period of self−isolation compared to the time before lockdown. We found that there was a significant decrease in the number of minutes asleep (−13.48%; −57.91; 95% CI, 16.33 to 99.49) among older adults. Finally, cardiovascular and pre-frailty risk scores were calculated based on biomarkers and evaluated from the clinical perspective. Full article
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Article
The Impact of the COVID-19 Pandemic on Psychological Health and Insomnia among People with Chronic Diseases
J. Clin. Med. 2021, 10(6), 1206; https://doi.org/10.3390/jcm10061206 - 14 Mar 2021
Cited by 7 | Viewed by 1371
Abstract
The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic highlighted the serious problems of health care systems but also threatened the mental and physical health of patients worldwide. The goal of this study was to assess psychological health and insomnia [...] Read more.
The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic highlighted the serious problems of health care systems but also threatened the mental and physical health of patients worldwide. The goal of this study was to assess psychological health and insomnia in people with chronic diseases in the time of elevated stress associated with the pandemic. The study involved 879 people from Zachodniopomorskie province in Poland. Each participant provided basic demographic data, data on symptoms of insomnia, depression, anxiety and information on concomitant diseases such as hypertension, diabetes mellitus, coronary heart disease, heart failure, dyslipidemia, chronic obstructive pulmonary disease, Hashimoto’s disease and smoking cigarettes. Chronic diseases included in this study showed a strong correlation between Hashimoto’s disease and increase scores according to the Insomnia Severity Index (ISI, r = 0.797, p < 0.001), the Generalized Anxiety Disorder scale (GAD-7, r = 0.766, p < 0.001) and the Patient Health Questionnaire (PHQ-9, r = 0.767, p < 0.001). After the results were corrected for age, gender, diagnosed hypertension, dyslipidemia and cigarette smoking, it was confirmed that the diagnosis of Hashimoto’s disease was associated with an increased risk of anxiety (odds ratio (OR) = 2.225; p < 0.001), depression (OR = 2.518; p < 0.001) and insomnia (OR = 3.530; p < 0.001). Our study showed that during the SARS-CoV-2 pandemic patients with Hashimoto’s disease show a higher risk of insomnia, anxiety and depression. Full article
Article
The Outbreak of SARS-CoV-2 Pandemic and the Well-Being of Polish Students: The Risk Factors of the Emotional Distress during COVID-19 Lockdown
J. Clin. Med. 2021, 10(5), 944; https://doi.org/10.3390/jcm10050944 - 01 Mar 2021
Cited by 5 | Viewed by 1470
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on both physical and mental health. The aim of this cross-sectional study was to (1) evaluate depression, anxiety, and stress levels among students from Polish universities during the first weeks of the COVID-19 [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on both physical and mental health. The aim of this cross-sectional study was to (1) evaluate depression, anxiety, and stress levels among students from Polish universities during the first weeks of the COVID-19 pandemic and (2) assess the risk factors of the higher intensity of emotional distress. We conducted an online survey using the Depression, Anxiety, and Stress Scale-21 (DASS-21) to assess well-being. The study included 2172 respondents (73% female, 27% male) with a mean age of 22.1 ± 2.2. Moderate to extremely severe scores of depression, anxiety, and stress were reported by 43.4%, 27.3%, and 41.0% of the respondents, respectively. Higher scores of DASS-21 were related to female sex (odds ratio (OR) = 3.01), studying sciences (OR = 2.04), co-residence with the roommates (OR = 1.25), suffering from a mental disorder (OR = 5.88), loneliness (OR = 293.30), the usage of psychiatric support before pandemic (OR = 8.06), poor economic situation (OR = 13.49), and the lower scores were found for being currently employed (OR = 0.4). This study highlights an urgent need for (1) crisis-oriented psychological and psychiatric support for students during the outbreak of the COVID-19 pandemic and (2) preparing appropriate psychological interventions to improve the mental health of students for a possible similar situation in the future. Full article
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Article
Influence of COVID-19 on Health-Related Quality of Life and the Perception of Being Vaccinated to Prevent COVID-19: An Approach for Community Pharmacists from Romania and Bulgaria
J. Clin. Med. 2021, 10(4), 864; https://doi.org/10.3390/jcm10040864 - 19 Feb 2021
Cited by 4 | Viewed by 1333
Abstract
Community pharmacists are essential front-line health workers, involved in relieving the COVID-19 burden. Their health-related quality of life status needs to be assessed, as lower levels could affect their functioning. In order to evaluate the current status of community pharmacists’ quality of life [...] Read more.
Community pharmacists are essential front-line health workers, involved in relieving the COVID-19 burden. Their health-related quality of life status needs to be assessed, as lower levels could affect their functioning. In order to evaluate the current status of community pharmacists’ quality of life from Romania and Bulgaria during the COVID-19 pandemic, and to identify factors associated with their decision on being vaccinated to prevent COVID-19, an online survey involving 395 community pharmacists was conducted from 15th July 2020 to 15th August 2020. The 15D instrument was used for quality-of-life assessment. The pharmacists’ recommendations for vitamin C and D intake during the COVID-19 pandemic were also analyzed in order to promote future training programs for community pharmacists. Descriptive statistics, comparative analyses between pharmacists from Romania and Bulgaria, and multiple correlation analyses were performed on the collected data. Significant differences were observed for the level of quality of life between the two groups of pharmacists according to their age; smaller values, directly correlated with their age (total 15D score and age: Spearman r = 0.168, p = 0.022), were obtained for Bulgarian pharmacists regarding sleeping, usual activities, mental function, discomfort and symptoms, depression, distress. The perception of being vaccinated did not differ between Romanian and Bulgarian pharmacists, as almost 50% agreed to vaccination (p = 0.7542). Their willingness to vaccinate was correlated with vitamin D usage (p = 0.0134), rather than with vitamin C (p = 0.4157). No other significant associations were found between willingness to get vaccinated to prevent COVID-19 and other characteristics (age, gender, income, quality-of-life markers). Evidence-based interventions are required to enhance the health-related quality of life of community pharmacists involved in the first line of the COVID-19 pandemic. Full article
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Article
The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo
J. Clin. Med. 2021, 10(4), 763; https://doi.org/10.3390/jcm10040763 - 14 Feb 2021
Cited by 5 | Viewed by 1125
Abstract
To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) [...] Read more.
To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) and sedentary behaviour in Kosovo. The possible association between PA levels and other factors was analyzed. 1633 participants (age range: 13 to 63 years; mean: 24.70 ± 9.33 years; body height: 172 ± 10.57 cm; body mass: 69.10 ± 13.80 kg; BMI: 23.09 ± 3.63 kg/m2) participated in the study, categorized by age, gender, BMI, and living area. An online survey, including an adapted version of the IPAQ-SF, was administered once during lockdown to assess PA levels and sedentary behaviour both before and during COVID-19 lockdown. The Wilcoxon signed-rank, Mann–Whitney U and Kruskal–Wallis rank of sum tests were used for statistical analysis. COVID-19 restrictions had a negative impact on the types of and overall PA levels MET-min/week (p < 0.001). Sedentary behaviour significantly increased during COVID-19 restrictions (p < 0.001). Higher decreases in MET-min/week during lockdown were observed among males, young and young adults, overweight, and urban-living participants. Finally, COVID-19 restrictions decreased the PA levels and MET-min/week, and increased sedentary behaviour also in a relatively young cohort. Such differences were dependent on several factors. Full article
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Article
Predictors of Threat from COVID-19: A Cross-Sectional Study in the Spanish Population
J. Clin. Med. 2021, 10(4), 692; https://doi.org/10.3390/jcm10040692 - 10 Feb 2021
Cited by 4 | Viewed by 1303
Abstract
One of the first measures for fighting the worldwide spread of the COVID-19 pandemic is social isolation or quarantine. The perceived threat from COVID-19 in this situation, maintained over time, generates uncertainty and fears, etc., which could lead to mental disorders in the [...] Read more.
One of the first measures for fighting the worldwide spread of the COVID-19 pandemic is social isolation or quarantine. The perceived threat from COVID-19 in this situation, maintained over time, generates uncertainty and fears, etc., which could lead to mental disorders in the population. This study evaluated the perceived threat from COVID-19 in the Spanish population. The study design was cross-sectional and observational. The sample of 1014 participants recruited in Spain had a mean age of 40.87 (SD = 12.42). The gender distribution was 67.2% (n = 681) women and 32.8% (n = 333) men. Data were collected with an online survey. The instrument used was the Perception of Threat from COVID-19 Questionnaire, validated for the Spanish population. Our data showed a clear correlation between perceived threat with female gender, having children in one’s care and level of education. However, no association was observed with age or marital status. Finally, we concluded that there is a greater perception of threat from COVID-19 by women with a lower education who have children in their care, and that they are also more sensitive to minor mental disorders, such as anxiety or stress, appearing. Full article
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Article
The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population
J. Clin. Med. 2021, 10(2), 289; https://doi.org/10.3390/jcm10020289 - 14 Jan 2021
Cited by 13 | Viewed by 2679
Abstract
The COVID-19 pandemic that has hit the world in the year 2020 has put a strain on our ability to cope with events and revolutionized our daily habits. On 9 March, Italy was forced to lockdown to prevent the spread of the infection, [...] Read more.
The COVID-19 pandemic that has hit the world in the year 2020 has put a strain on our ability to cope with events and revolutionized our daily habits. On 9 March, Italy was forced to lockdown to prevent the spread of the infection, with measures including the mandatory closure of schools and nonessential activities, travel restrictions, and the obligation to spend entire weeks in the same physical space. The aim of this study was to assess the impact of the COVID-19 pandemic and lockdown measures on quality of life (QoL) in a large Italian sample, in order to investigate possible differences in QoL levels related to both demographic and pandemic-specific variables. A total of 2251 Italian adults (1665 women, mainly young and middle adults) were recruited via a snowball sampling strategy. Participants were requested to answer to an online survey, which included demographic and COVID-related information items, and the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF). The results showed statistically significant differences in QoL depending on a number of variables, including sex, area of residence in Italy, and being diagnosed with a medical/psychiatric condition. To our knowledge, this is the first study to assess QoL during COVID-19 pandemic in Italy, therefore the present findings can offer guidelines regarding which social groups are more vulnerable of a decline in QoL and would benefit of psychological interventions. Full article
Article
The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study
J. Clin. Med. 2021, 10(1), 52; https://doi.org/10.3390/jcm10010052 - 25 Dec 2020
Cited by 10 | Viewed by 1489
Abstract
The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended [...] Read more.
The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended to Italy and several other countries. This article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyze the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, COVID-19 anxiety. In line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14, 51.15% females) taken from four regions: Lombardia, Veneto, Lazio, and Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models. Somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with mourning a loss of a beloved one due to COVID-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and COVID-19 related anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged. The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting COVID-19 within one month. In Italy, unlike the UK, lower household income and having (had) COVID-19 were not associated with poorer mental health. The psychological impact of COVID-19 can last for months; future research should explore all aspects of the psychological burden of COVID-19 in order to implement psychological interventions and promote psychological health. Full article
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Article
Forced Cohabitation during Coronavirus Lockdown in Italy: A Study on Coping, Stress and Emotions among Different Family Patterns
J. Clin. Med. 2020, 9(12), 3906; https://doi.org/10.3390/jcm9123906 - 01 Dec 2020
Cited by 8 | Viewed by 2196
Abstract
Background: At the beginning of 2020, a pandemic caused by a new strain of coronavirus occurred. On March 9th, the Italian population was forced to lockdown to prevent the spread of this new virus. This event forced families and cohabitants to spend their [...] Read more.
Background: At the beginning of 2020, a pandemic caused by a new strain of coronavirus occurred. On March 9th, the Italian population was forced to lockdown to prevent the spread of this new virus. This event forced families and cohabitants to spend their entire days and weeks in the same physical space, interacting with partners and children with a very different degree of intimacy than in the earlier situation. The present study investigated the effects of being forced to live together on different family patterns, on various dimensions such as stress, coping strategies, time perception and quality evaluation of cohabitation. Method: A total sample consisting of 1750 individuals was recruited through a random sample of probability across the Italian country. Due to the lockdown condition, an online questionnaire was set up; several validated scales were chosen, and some open-ended items were included for the thoughts of the participants. Results: The results showed statistically significant differences between the three family patterns examined. Conclusion: During the forced period of living together, a positive effect could be inferred as given by the presence of children and the collaborative coping strategies that have been adopted; the results have been discussed according to the literature on the topic. Full article
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Article
Effects of Spirituality, Knowledge, Attitudes, and Practices toward Anxiety Regarding COVID-19 among the General Population in INDONESIA: A Cross-Sectional Study
J. Clin. Med. 2020, 9(12), 3798; https://doi.org/10.3390/jcm9123798 - 24 Nov 2020
Cited by 4 | Viewed by 1574
Abstract
Background: Currently, the determinants of anxiety and its related factors in the general population affected by COVID-19 are poorly understood. We examined the effects of spirituality, knowledge, attitudes, and practices (KAP) on anxiety regarding COVID-19. Methods: Online cross-sectional data (n = 1082) [...] Read more.
Background: Currently, the determinants of anxiety and its related factors in the general population affected by COVID-19 are poorly understood. We examined the effects of spirituality, knowledge, attitudes, and practices (KAP) on anxiety regarding COVID-19. Methods: Online cross-sectional data (n = 1082) covered 17 provinces. The assessment included the Daily Spiritual Experiences Scale, the Depression, Anxiety, and Stress Scale, and the KAP-COVID-19 questionnaire. Results: Multiple linear regression revealed that individuals who had low levels of spirituality had increased anxiety compared to those with higher levels of spirituality. Individuals had correct knowledge of early symptoms and supportive treatment (K3), and that individuals with chronic diseases and those who were obese or elderly were more likely to be severe cases (K4). However, participants who chose incorrect concerns about there being no need for children and young adults to take measures to prevent COVID-19 (K9) had significantly lower anxiety compared to those who responded with the correct choice. Participants who disagreed about whether society would win the battle against COVID-19 (A1) and successfully control it (A2) were associated with higher anxiety. Those with the practice of attending crowded places (P1) had significantly higher anxiety. Conclusions: Spirituality, knowledge, attitudes, and practice were significantly correlated with anxiety regarding COVID-19 in the general population. Full article
Article
Psychological and Emotional Impact of Patients Living in Psychiatric Treatment Communities during Covid-19 Lockdown in Italy
J. Clin. Med. 2020, 9(11), 3787; https://doi.org/10.3390/jcm9113787 - 23 Nov 2020
Cited by 12 | Viewed by 1491
Abstract
Most studies on well-being during the COVID-19 pandemic have focused on the mental health of the general population; far less attention has been given to more specific populations, such as patients with mental illness. Indeed, it is important to examine the psychiatric population, [...] Read more.
Most studies on well-being during the COVID-19 pandemic have focused on the mental health of the general population; far less attention has been given to more specific populations, such as patients with mental illness. Indeed, it is important to examine the psychiatric population, given its vulnerability. The present study aimed at assessing the psychological and emotional impact of isolation on patients in Residential Rehabilitation Communities, compared to healthy controls. A questionnaire was administered cross-sectionally on an online survey platform and both psychiatric patients and healthy controls accessed via a designed link. The results showed significant differences between psychiatric patients and controls on Anxiety, Stress, Worry, and Risk Perception variables. Psychiatric patients scored lower on Stress compared to healthy controls and higher on Anxiety, Perceived Risk of getting infected with COVID-19 and Worry about the emergency situation. The results showed that, during the Italian lockdown, psychiatric patients living in residential communities received unbroken support from peers and mental health professionals, maintained their usual medication treatment, and were informed of COVID-19 consequences. This finding provides insight into the differences between residential and healthy populations and highlights the importance of continuous support for psychiatric patients, especially during stressful situations such as a pandemic. Full article
Article
Mental Health, Sense of Coherence, and Interpersonal Violence during the COVID-19 Pandemic Lockdown in Germany
J. Clin. Med. 2020, 9(11), 3708; https://doi.org/10.3390/jcm9113708 - 18 Nov 2020
Cited by 9 | Viewed by 2222
Abstract
Preliminary data indicates that the Coronavirus SARS-CoV-2 disease (COVID-19) pandemic may have a substantial impact on mental health and well-being. We assessed mental health in response to the lockdown in Germany between 1 April 2020 and 15 April 2020 using a cross-sectional online [...] Read more.
Preliminary data indicates that the Coronavirus SARS-CoV-2 disease (COVID-19) pandemic may have a substantial impact on mental health and well-being. We assessed mental health in response to the lockdown in Germany between 1 April 2020 and 15 April 2020 using a cross-sectional online survey (n = 3545) with a mixed-methods approach. We found increased levels of psychosocial distress (Patient Health Questionnaire (PHQ) stress module), anxiety, depressive symptoms (PHQ-4), irritability, and a decrease in overall well-being (WHO-Five Well-Being Index (WHO-5)), sense of coherence (Short Form of the Sense of Coherence Scale (SOC-L9)), sexual contentment, and sleep quality. The four-week-prevalence of interpersonal violence was yet at 5% and included verbal, physical, and sexual violence. Participants reported finding comfort in family, friends, conversation, exercise, and activity. Findings are also in line with research showing that women seem to have more trouble coping with the pandemic and lockdown measures. Our observations demonstrate that the COVID-19 pandemic and related measures lead to a mental health burden even in a highly developed Western country and should, therefore, be taken seriously. The findings for interpersonal violence are alarming. Thus, we should sharpen our focus on the matter and activate and enhance supporting systems to help protect those affected. Full article
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Article
Relationship of Forced Social Distancing and Home Confinement Derived from the COVID-19 Pandemic with the Occupational Balance of the Spanish Population
J. Clin. Med. 2020, 9(11), 3606; https://doi.org/10.3390/jcm9113606 - 09 Nov 2020
Cited by 3 | Viewed by 1383
Abstract
Abrupt interruption in the performance of everyday occupations as a consequence of forced social distancing and home confinement, coupled with a lack of regulatory capacities and skills, can trigger harmful effects on people’s health and well-being. This study aimed to determine the factors [...] Read more.
Abrupt interruption in the performance of everyday occupations as a consequence of forced social distancing and home confinement, coupled with a lack of regulatory capacities and skills, can trigger harmful effects on people’s health and well-being. This study aimed to determine the factors related to the occupational balance in the Spanish population during home confinement as a consequence of the coronavirus disease 19 (COVID-19) pandemic. A total of 3261 subjects completed an online survey, which was disseminated through the mainstream social media platforms in Spain and included the Occupational Balance Questionnaire (OBQ), sociodemographic variables, and factors related to COVID-19 infection. The mean age of the participants (81.69% women) was 40.53 years (SD ± 14.05). Sociodemographic variables were related to a greater occupational balance, and the multivariate analysis showed that age (β = 0.071; p = 0.001), the perception of having received enough information (β = 0.071; p ≤ 0.001), not telecommuting (β = −0.047; p = 0.022), and not being infected by COVID-19 (β = 0.055; p = 0.007) contributed to a better occupational balance. There were profiles of people less likely to suffer disturbances in occupational balance during home confinement, but more studies are needed to help understand and analyze the effects of the COVID-19 pandemic on people’s occupational and mental health. Full article
Article
Impact of COVID-19 Lockdown Measures on Spanish People with Chronic Pain: An Online Study Survey
J. Clin. Med. 2020, 9(11), 3558; https://doi.org/10.3390/jcm9113558 - 05 Nov 2020
Cited by 6 | Viewed by 1978
Abstract
The corona virus disease 2019 (COVID-19) pandemic is one of the most important healthcare and societal challenges to have emerged in the last century. It may have effects on both physical and psychosocial health, but studies considering the impact on vulnerable populations, such [...] Read more.
The corona virus disease 2019 (COVID-19) pandemic is one of the most important healthcare and societal challenges to have emerged in the last century. It may have effects on both physical and psychosocial health, but studies considering the impact on vulnerable populations, such as people with chronic pain, are needed. In this cross-sectional study, an online survey of relevant chronic pain domains, coping strategies, triggers and potential related variables was answered by 502 Spanish individuals with chronic pain. Participants were mainly women (88%) with longstanding chronic pain and moderate to high pain intensity and disability. The perception of pain aggravation and the most pain-related outcomes were observed. Contextual variables such as job insecurity, worries about the future, people cohabiting, being close to someone who had passed away, or being potentially infected with COVID-19 were related to worse outcomes. More than half the participants altered their pain management style (e.g., increased medication intake) and several changes occurred with respect to pain triggers (cognitions, feelings of insecurity and loneliness, and sleeping problems were more frequently reported as triggers during lockdown). Our preliminary results highlight the negative effects of lockdown on patients with chronic pain as well as the need to make available cost-effective and remotely accessible healthcare resources for counteracting them. Full article
Article
Does Physical Activity Matter for the Mental Health of University Students during the COVID-19 Pandemic?
J. Clin. Med. 2020, 9(11), 3494; https://doi.org/10.3390/jcm9113494 - 29 Oct 2020
Cited by 15 | Viewed by 3160
Abstract
Research indicates that university and college students are at higher risk of experiencing mental health problems than other populations. This study aims to examine the relationship between Physical Activity (PA) and the mental health of Ukrainian university students during the Corona Virus Disease [...] Read more.
Research indicates that university and college students are at higher risk of experiencing mental health problems than other populations. This study aims to examine the relationship between Physical Activity (PA) and the mental health of Ukrainian university students during the Corona Virus Disease 2019 (COVID-19) pandemic lockdown. The conventional sample consisted of 1512 students from 11 Ukrainian universities, with a mean age of 20 years (M = 20.06, SD = 3.05) and 69% of whom were female. The cross-sectional online survey was disseminated through the most popular social media channels in Ukraine (i.e., Facebook, Viber, Telegram) and included the Generalized Anxiety Disorder (GAD-7) scale to measure anxiety and the Patient Health Questionnaire (PHQ-9) to assess depression. Data were collected from 14 May to 4 June 2020 during the COVID-19 pandemic outbreak in Ukraine. Among university students, 43% were engaged in PA ≥ 150 min weekly, 24% met the criteria of GAD, and 32% met the criteria of depression. More students were involved in PA before the COVID-19 outbreak than during the national lockdown. Students with anxiety and depression were almost two times less likely to engage in PA than their counterparts without mental health disorders. The inactive group had higher scores of anxiety and depression than the physically active group. The relationship of PA with anxiety and depression was statistically significant but weak during the COVID-19 pandemic. Full article
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Increased Psychological Distress during COVID-19 and Quarantine in Ireland: A National Survey
J. Clin. Med. 2020, 9(11), 3481; https://doi.org/10.3390/jcm9113481 - 28 Oct 2020
Cited by 23 | Viewed by 3547
Abstract
Background: The emergence of the coronavirus pneumonia (COVID-19) resulted in a global pandemic. The psychological impact of an epidemic is multifaceted and acute, with long-term consequences. Methods: A cross-sectional online survey-based design was employed, assessing the psychological impact of COVID-19 on members of [...] Read more.
Background: The emergence of the coronavirus pneumonia (COVID-19) resulted in a global pandemic. The psychological impact of an epidemic is multifaceted and acute, with long-term consequences. Methods: A cross-sectional online survey-based design was employed, assessing the psychological impact of COVID-19 on members of the Irish public during the quarantine period of COVID-19 in Ireland. Participants were invited to complete the Depression, Anxiety, and Stress Scale-21 (DASS-21) retrospectively (prior to quarantine) and during the quarantine period, as well as measures of illness perceptions, well-being, and a bespoke measure (the Effects of COVID Questionnaire, ECQ), which assessed perceptions of COVID-related stresses associated with personal concerns, caring for children, caring for aging parents, as well as gratitude. Results: A total of n = 1620 entered the survey platform, with a total of n = 847 surveys completed by members of the Irish public. Entry into COVID-19 quarantine was associated with significant increases in clinically significant symptoms of depression, stress, and anxiety. The ECQ reliably assessed a range of COVID-19-related stresses and had large and significant correlations with the DASS-21. Conclusions: The COVID-19 quarantine was associated with stresses and significant increases in symptoms of depression, anxiety, and stress in a national Irish cohort. The public require increased access to mental health services to meet this increase in COVID-19-related psychological distress. Full article
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Article
Predicting Perceived Stress Related to the Covid-19 Outbreak through Stable Psychological Traits and Machine Learning Models
J. Clin. Med. 2020, 9(10), 3350; https://doi.org/10.3390/jcm9103350 - 19 Oct 2020
Cited by 45 | Viewed by 4238
Abstract
The global SARS-CoV-2 outbreak and subsequent lockdown had a significant impact on people’s daily lives, with strong implications for stress levels due to the threat of contagion and restrictions to freedom. Given the link between high stress levels and adverse physical and mental [...] Read more.
The global SARS-CoV-2 outbreak and subsequent lockdown had a significant impact on people’s daily lives, with strong implications for stress levels due to the threat of contagion and restrictions to freedom. Given the link between high stress levels and adverse physical and mental consequences, the COVID-19 pandemic is certainly a global public health issue. In the present study, we assessed the effect of the pandemic on stress levels in N = 2053 Italian adults, and characterized more vulnerable individuals on the basis of sociodemographic features and stable psychological traits. A set of 18 psycho-social variables, generalized regressions, and predictive machine learning approaches were leveraged. We identified higher levels of perceived stress in the study sample relative to Italian normative values. Higher levels of distress were found in women, participants with lower income, and participants living with others. Higher rates of emotional stability and self-control, as well as a positive coping style and internal locus of control, emerged as protective factors. Predictive learning models identified participants with high perceived stress, with a sensitivity greater than 76%. The results suggest a characterization of people who are more vulnerable to experiencing high levels of stress during the COVID-19 pandemic. This characterization may contribute to early and targeted intervention strategies. Full article
Article
A Predictive Study of Resilience and Its Relationship with Academic and Work Dimensions during the COVID-19 Pandemic
J. Clin. Med. 2020, 9(10), 3258; https://doi.org/10.3390/jcm9103258 - 12 Oct 2020
Cited by 3 | Viewed by 1561
Abstract
Background: The aim of the present study was to describe the resilience levels in a Spanish population during the Coronavirus (COVID-19) pandemic and to analyze the existing associations between high resilience and socio-demographic, work, and academic parameters. Method: 1176 individuals aged 18–67 years [...] Read more.
Background: The aim of the present study was to describe the resilience levels in a Spanish population during the Coronavirus (COVID-19) pandemic and to analyze the existing associations between high resilience and socio-demographic, work, and academic parameters. Method: 1176 individuals aged 18–67 years participated in a descriptive cross-sectional study. The participants were administered the 10-item resilience scale developed by Connor-Davidson (CD-RISC-10) and an ad-hoc questionnaire that collected information on socio-demographic, work, and academic variables. Basic descriptive data were used to statistically analyze the data, and a binary logistic regression model was developed incorporating the professional occupation, academic level, whether the respondent worked in emergency services, and whether the respondent had dependents. Results: Slightly more than a quarter of the participants showed low resilience, almost half reported moderate resilience, and slightly more than a quarter had high resilience. Those who were employed were 2.16-times more likely to have high resilience, whilst those with higher education were 1.57-times more likely. Those working in emergency services were 1.66-times more likely, and those with dependents were 1.58-times more likely to have high resilience. Conclusion: In addition to the relationships found, a need to improve the resilience levels in the population was found. Full article
Article
Risk Perception of COVID-19, Meaning-Based Resources and Psychological Well-Being amongst Healthcare Personnel: The Mediating Role of Coping
J. Clin. Med. 2020, 9(10), 3225; https://doi.org/10.3390/jcm9103225 - 08 Oct 2020
Cited by 13 | Viewed by 1942
Abstract
The well-being of healthcare personnel during the COVID-19 pandemic depends on the ways in which they perceive the threat posed by the virus, personal resources, and coping abilities. The current study aims to examine the mediating role of coping strategies in the relationship [...] Read more.
The well-being of healthcare personnel during the COVID-19 pandemic depends on the ways in which they perceive the threat posed by the virus, personal resources, and coping abilities. The current study aims to examine the mediating role of coping strategies in the relationship between risk perception of COVID-19 and psychological well-being, as well as the relationship between meaning-based resources and psychological well-being amongst healthcare personnel in southern Poland. Two hundred and twenty-six healthcare personnel who worked in hospitals, outpatient clinics, and medical laboratories during the first few months of the coronavirus pandemic (March–May 2020) filled in questionnaires measuring risk perception of COVID-19, meaning-based resources, coping, and psychological well-being. The results demonstrate that risk perception was negatively related to psychological well-being, whereas meaning-based resources were positively associated with well-being. Two coping strategies—problem-focused and meaning-focused coping—mediated the relationship between risk perception and psychological well-being as well as the relationship between meaning-based resources and psychological well-being. This indicates that perception processes and personal factors do not directly influence healthcare personnel’s psychological well-being, but rather they do indirectly through coping processes. Full article
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Article
Anxiety in Older Adolescents at the Time of COVID-19
J. Clin. Med. 2020, 9(10), 3064; https://doi.org/10.3390/jcm9103064 - 23 Sep 2020
Cited by 19 | Viewed by 4312
Abstract
Corona Virus Disease-19 (COVID-19) is a catastrophic health risk, with psychological, emotional, social, and relational implications. From the early stages of the virus spread, the elderly population was identified as the most vulnerable, and health authorities have rightly focused on this frailer population. [...] Read more.
Corona Virus Disease-19 (COVID-19) is a catastrophic health risk, with psychological, emotional, social, and relational implications. From the early stages of the virus spread, the elderly population was identified as the most vulnerable, and health authorities have rightly focused on this frailer population. Conversely, less attention was given to the emotional and psychological dimensions of children and adolescents. Moreover, even though they were the subjects whose lives and health were at low risk, they, nevertheless, had to face a reality full of anxiety, fears, and uncertainties. The current study investigated the state of anxiety and emotional awareness in a sample of healthy older adolescents, 84 females and 64 males, aged 17 to 19, during the pandemic lockdown, using the Self-Rating Anxiety Scale and the Italian Emotion Awareness Questionnaire. An unexpected anxious phenomenology was found, affecting anxiety and the ideo-affective domain, while somatic symptomatology appeared to be less severe. The highest anxiety symptoms were breathing difficulties. These findings supported the hypothesis that the COVID-19 pandemic may be a risk condition for an increased state of anxiety in older adolescents and suggested the need to provide (1) an effective, empathic communication system with direct participation of older adolescents, (2) a psychological counseling service for the stress management of adolescents. Full article
Article
Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain
J. Clin. Med. 2020, 9(9), 3029; https://doi.org/10.3390/jcm9093029 - 20 Sep 2020
Cited by 36 | Viewed by 4713
Abstract
Background: The health profession is a burnout producer due to the continuous contact with pain and suffering. In addition, excessive workloads can generate stress and psychological distress. Objectives: The aim of this study was to determine the degree of burnout and its main [...] Read more.
Background: The health profession is a burnout producer due to the continuous contact with pain and suffering. In addition, excessive workloads can generate stress and psychological distress. Objectives: The aim of this study was to determine the degree of burnout and its main triggers in health professionals in Spain at the most critical period of the COVID-19 emergency. Method: A quantitative research was developed through a simple random sampling in different Spanish hospitals through the period of greatest impact of the pandemic (N = 157). Data were collected using a standardized questionnaire from Maslach burnout inventory (MBI) containing 22 items, which measures three subscales: emotional burnout, depersonalization, and self-fulfillment. Results: depersonalization values reached 38.9%. A total of 90.4% of the health professionals considered that psychological care should be provided from the work centers. Furthermore, 43.3% of the health professionals estimated that they might need psychological treatment in the future. Finally, 85.4% stated that the lack of personal protective equipment (PPE) generated an increase in stress and anxiety. Conclusion: This study demonstrates the need to consider specific mental health care services and training in crises to avoid possible psychological disorders. The information obtained is also valuable for the development of future prevention protocols and training of health personnel to face pandemics of these characteristics or emergency scenarios. Having the necessary physical means for their protection, as well to updated regular and accurate information, is essential to avoid feelings of fear and uncertainty. This would promote the health of these professionals. Full article
Article
Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey
J. Clin. Med. 2020, 9(9), 2976; https://doi.org/10.3390/jcm9092976 - 15 Sep 2020
Cited by 18 | Viewed by 2151
Abstract
Background: Isolation measures used to contain epidemics generate social interaction restrictions and impose changes in routines of the public that increase negative psychological outcomes. Anxiety and depression are the most common symptoms. Objective: To evaluate the mental health of the Brazilian population during [...] Read more.
Background: Isolation measures used to contain epidemics generate social interaction restrictions and impose changes in routines of the public that increase negative psychological outcomes. Anxiety and depression are the most common symptoms. Objective: To evaluate the mental health of the Brazilian population during the SARs-CoV-2 pandemic and its relationship with demographic and health characteristics. Methods: Adults from all Brazilian States participated (n = 12,196; women: 69.8%, mean age = 35.2 years). The Depression, Anxiety and Stress Scale, and the Impact of Event Scale–revised were used (online survey). Data validity and reliability were verified by confirmatory factor analysis and ordinal alpha coefficient. The probability of presenting psychological symptoms was calculated by multiple logistic regression and odds ratio (OR) (0 = without symptoms, 1 = with mild, moderate, and severe levels of symptoms). Results: High prevalence of depression (61.3%), anxiety (44.2%), stress (50.8%), and psychological impact (54.9%) due to the isolation experienced from the pandemic was found. Younger individuals (OR = 1.58–3.58), those that felt unsafe (OR = 1.75–2.92), with a previous diagnosis of mental health (OR = 1.72–2.64) and/or had general health problems before the pandemic (OR = 1.17–1.51), who noticed changes in their mental state due to the pandemic context (OR = 2.53–9.07), and excessively exposed to the news (OR = 1.19–2.18) were at increased risk of developing symptoms. Women (OR = 1.35–1.65) and those with lower economic status (OR = 1.38–2.69) were more likely to develop psychological symptoms. Lower educational levels increased the likelihood of depressive (OR = 1.03–1.34) and intrusive symptoms (OR = 1.09–1.51). Conclusions: The pandemic and related factors can have a high impact on the mental health of the population. Demographic characteristics can influence the occurrence of psychological symptoms. Full article
Article
Evaluation of Mental Health Factors among People with Systemic Lupus Erythematosus during the SARS-CoV-2 Pandemic
J. Clin. Med. 2020, 9(9), 2872; https://doi.org/10.3390/jcm9092872 - 05 Sep 2020
Cited by 11 | Viewed by 1723
Abstract
There are considerable psychological and psychiatric consequences of the pandemic. Researchers have started to take into account the real or perceived sense of social threats that may be expressed, such as anxiety, depression, and sleep disorders. However, analyses on pandemic-related anxiety, depression, and [...] Read more.
There are considerable psychological and psychiatric consequences of the pandemic. Researchers have started to take into account the real or perceived sense of social threats that may be expressed, such as anxiety, depression, and sleep disorders. However, analyses on pandemic-related anxiety, depression, and sleep disorders mostly rarely addresses the situation of people with autoimmune diseases. Therefore, the aim of this study was to assess the mental health factors among people with systemic lupus erythematosus by quantifying the severity of anxiety, depression, and sleep disorders during the SARS-CoV-2 pandemic. In total, 723 people took part in the study. The study group consisted of 134 individuals with a systemic lupus erythematosus. The control group consisted of 589 people without systemic lupus erythematosus. The regression adjusted by age, gender, and diagnosis of other chronic diseases showed individuals with systemic lupus erythematosus were at a much higher risk of elevated symptoms of anxiety on the GAD-7 scale (OR = 3.683; p < 0.001), depression on the PHQ-9 scale (OR = 4.183; p < 0.001), and sleep disorders on the Insomnia Severity Index (ISI) scale (OR = 6.781; p < 0.001). Therefore, the mental health of patients with systemic lupus erythematosus in the times of the SARS-CoV-2 pandemic is not only an extremely important medical problem but also a social one and must require special attention. Full article
Article
Prevalence of Antibodies to SARS-CoV-2 in Italian Adults and Associated Risk Factors
J. Clin. Med. 2020, 9(9), 2780; https://doi.org/10.3390/jcm9092780 - 27 Aug 2020
Cited by 26 | Viewed by 2053
Abstract
We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included [...] Read more.
We aimed to assess the prevalence of and factors associated with anti- severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positivity in a large population of adult volunteers from five administrative departments of the Liguria and Lombardia regions. A total of 3609 individuals were included in this analysis. Participants were tested for anti-SARS-CoV-2 antibodies [Immunoglobulin G (IgG) and M (IgM) class antibodies] at three private laboratories (Istituto Diganostico Varelli, Medical Center, and Casa della Salute di Genova). Demographic data, occupational or private exposure to SARS-CoV-2-infected patients, and prior medical history consistent with SARS-CoV-2 infection were collected according to a preplanned analysis. The overall seroprevalence of anti-SARS-CoV-2 antibodies (IgG and/or IgM) was 11.0% [398/3609; confidence interval (CI) 10.0%–12.1%]. Seroprevalence was higher in female inmates than in male inmates (12.5% vs. 9.2%, respectively, p = 0.002), with the highest rate observed among adults aged >55 years (13.2%). A generalized estimating equations model showed that the main risk factors associated with SARS-CoV-2 seroprevalence were the following: an occupational exposure to the virus [Odd ratio (OR) = 2.36; 95% CI 1.59–3.50, p = 0.001], being a long-term care facility resident (OR = 4.53; 95% CI 3.19–6.45, p = 0.001), and reporting previous symptoms of influenza-like illness (OR = 4.86; 95% CI 3.75–6.30, p = 0.001) or loss of sense of smell or taste (OR = 41.00; 95% CI 18.94–88.71, p = 0.001). In conclusion, we found a high prevalence (11.0%) of SARS-CoV-2 infection that is significantly associated with residing in long-term care facilities or occupational exposure to the virus. These findings warrant further investigation into SARS-CoV-2 antibody prevalence among the Italian population. Full article
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Article
COVID-19 Pandemic Outbreak and its Psychological Impact on Patients with Rare Lysosomal Diseases
J. Clin. Med. 2020, 9(9), 2716; https://doi.org/10.3390/jcm9092716 - 22 Aug 2020
Cited by 9 | Viewed by 1191
Abstract
Background: Lysosomal storage disorders (LSDs) are rare, chronic, progressive multisystem diseases implying severe medical issues and psychological burden. Some of these disorders are susceptible to a treatment, which is administered weekly or every other week, in a hospital. During the COVID-19 (Corona Virus [...] Read more.
Background: Lysosomal storage disorders (LSDs) are rare, chronic, progressive multisystem diseases implying severe medical issues and psychological burden. Some of these disorders are susceptible to a treatment, which is administered weekly or every other week, in a hospital. During the COVID-19 (Corona Virus Disease 2019) pandemic lockdown, patients with LSDs on enzyme replacement therapy (ERT) missed their scheduled access to the Day Hospital to get their treatment. Methods: Based on the feeling that our patients were experiencing profound distress, we designed a structured telephone interview with the aim to evaluate how, and to which extent, the pandemic outbreak was changing their behavior and feelings about their chronic disease, the impact on therapies, and future expectations. The same interview was administered to an age-matched control group. Results: All interviewed people experienced an increase of anxiety, worries, and uncertainty fostered by incessant media updates. Moreover, a striking similarity emerged between the groups regarding forced home reclusion and the profound feeling to be excluded by normal life, well-known to those affected by a chronic rare disease. Conclusions: Although no statistically significant difference was found compared to controls, we felt that the reactions were qualitatively different, underlining the fragility and isolation of such patients. Full article
Article
Mental Health of Medical and Non-Medical Professionals during the Peak of the COVID-19 Pandemic: A Cross-Sectional Nationwide Study
J. Clin. Med. 2020, 9(8), 2527; https://doi.org/10.3390/jcm9082527 - 05 Aug 2020
Cited by 23 | Viewed by 3638
Abstract
Background: The study aimed to compare psychopathological expressions during the COVID-19 (novel coronavirus disease 2019) pandemic, as declared on March 11th 2020 by the World Health Organization, with respect to which institutional variables might distinguish the impact of COVID-19 in medical and non-medical [...] Read more.
Background: The study aimed to compare psychopathological expressions during the COVID-19 (novel coronavirus disease 2019) pandemic, as declared on March 11th 2020 by the World Health Organization, with respect to which institutional variables might distinguish the impact of COVID-19 in medical and non-medical professionals. Methods: A cross-sectional study was performed nationwide between 16th March and the 26th April 2020 in Poland. A total of 2039 respondents representing all healthcare providers (59.8%) as well as other professionals filled in the sociodemographic section, the General Health Questionnaire-28 and the author’s questionnaire with questions related to exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the availability of protective measures, quarantine, change of working hours and place of employment during the pandemic, as well as feelings associated with the state of the pandemic. Results: Medical professionals more often presented with relevant psychopathological symptoms (GHQ-28 (General Health Questionnaire-28) total score >24) than the non-medical group (60.8% vs. 48.0%, respectively) such as anxiety, insomnia and somatic symptoms even after adjustment for potential confounding factors. Male sex, older age and appropriate protective equipment were associated with significantly lower GHQ-28 total scores in medical professionals, whereas among non-medical professionals, male sex was associated with significantly lower GHQ-28 total scores. Conclusions: Somatic and anxiety symptoms as well as insomnia are more prevalent among medical staff than workers in other professions. Targeting the determinants of these differences should be included in interventions aimed at restoring psychological well-being in this specific population. Apparently, there are present gender differences in psychological responses that are independent of profession. Full article
Article
Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic
J. Clin. Med. 2020, 9(8), 2449; https://doi.org/10.3390/jcm9082449 - 31 Jul 2020
Cited by 15 | Viewed by 2503
Abstract
Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the “coronavirus disease 2019” (COVID-19) pandemic, [...] Read more.
Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the “coronavirus disease 2019” (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic. Study design: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. Results: Women hospitalized during the COVID-19 strict isolation period (n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic (n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52–1.93, p = 0.985). Conclusion: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic. Full article
Article
Phase 2 and Later of COVID-19 Lockdown: Is it Possible to Perform Remote Diagnosis and Intervention for Autism Spectrum Disorder? An Online-Mediated Approach
J. Clin. Med. 2020, 9(6), 1850; https://doi.org/10.3390/jcm9061850 - 13 Jun 2020
Cited by 16 | Viewed by 3749
Abstract
COVID-19 is still in phase 2. The lockdown has been significantly reduced compared to phase 1. The centers and institutions that deal with the diagnosis and intervention of children with autism spectrum disorder (ASD) require rapid functional adaptation to respond to patients’ needs. [...] Read more.
COVID-19 is still in phase 2. The lockdown has been significantly reduced compared to phase 1. The centers and institutions that deal with the diagnosis and intervention of children with autism spectrum disorder (ASD) require rapid functional adaptation to respond to patients’ needs. The possibility of using technology to activate and manage diagnostic (preliminary diagnosis) and intervention processes should be explored. Two developed telemedicine working models for diagnosis and intervention, including synchronous and asynchronous transmissions, are presented. They are proposals not yet supported by the data. The diagnosis step is composed by two different and consecutives phases: (A) pre-specialistic consultation (PSC) and (B) specialistic assessment. The intervention step implemented well-recognized evidence-based models for preschoolers, school-aged, and older children in an online format. Parents’ support is also included. The described working models have the purpose of carrying out preliminary specialistic answers to the families without aiming to replace preferable in-person assessment. Based on previous research findings, the telemedicine approach is accepted by parents, increases their sense of competence, increases the parent intervention adhesion, and improves the social communication competencies for children with ASD. In conclusion, the presented working models must be considered partial responses to the current emergency status and at the same time as possible integrations into traditional approaches. Full article
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Article
The Enemy Which Sealed the World: Effects of COVID-19 Diffusion on the Psychological State of the Italian Population
J. Clin. Med. 2020, 9(6), 1802; https://doi.org/10.3390/jcm9061802 - 10 Jun 2020
Cited by 66 | Viewed by 2561
Abstract
Background: Starting from the first months of 2020, worldwide population has been facing the COVID-19 pandemic. Many nations, including Italy, took extreme actions to reduce the diffusion of the virus, profoundly changing lifestyles. The Italians have been faced with both the fear of [...] Read more.
Background: Starting from the first months of 2020, worldwide population has been facing the COVID-19 pandemic. Many nations, including Italy, took extreme actions to reduce the diffusion of the virus, profoundly changing lifestyles. The Italians have been faced with both the fear of contracting the infection and the consequences of enforcing social distancing. This study was aimed to understand the psychological impact of the COVID-19 outbreak and the psychopathological outcomes related to the first phase of this emergency. Methods: The study included 2291 respondents. An online survey collected information on socio-demographic variables, history of direct or indirect contact with COVID-19, and additional information concerning the COVID-19 emergency. Moreover, psychopathological symptoms such as anxiety, mood alterations and post-traumatic symptomatology were assessed. Results: The results revealed that respectively 31.38%, 37.19% and 27.72% of respondents reported levels of general psychopathological symptomatology, anxiety, and PTSD symptoms over the cut-off scores. Furthermore, a significant worsening of mood has emerged. Being a female or under the age of 50 years, having had direct contact with people infected by the COVID-19, and experiencing uncertainty about the risk of contagion represent risk factors for psychological distress. Conclusions: Our findings indicate that the first weeks of the COVID-19 pandemic appear to impact not only on physical health but also on psychological well-being. Although these results need to be considered with caution being based on self-reported data collected at the beginning of this emergency, they should be used as a starting point for further studies aimed to develop interventions to minimize both the brief and long-term psychological consequences of the COVID-19 pandemic. Full article
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Review

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Review
A Systematic Review on Detraining Effects after Balance and Fall Prevention Interventions
J. Clin. Med. 2021, 10(20), 4656; https://doi.org/10.3390/jcm10204656 - 11 Oct 2021
Viewed by 285
Abstract
Since the COVID-19 pandemic hit, lockdowns have been implemented to fight off infections in countries around the world. Whilst this measure is without a doubt effective against spreading infection, it might also decrease participation in exercise. For older adults, exercise is particularly important [...] Read more.
Since the COVID-19 pandemic hit, lockdowns have been implemented to fight off infections in countries around the world. Whilst this measure is without a doubt effective against spreading infection, it might also decrease participation in exercise. For older adults, exercise is particularly important in the prevention of falls, and sudden detraining because of a lockdown or due to other causes might have detrimental consequences. This systematic review study aims to assess what is currently known on detraining effects for balance outcomes. Nine studies were included within this review. Results suggest that detraining effects could already be significant as early as 4 weeks after stopping the intervention. Programs that specifically focus on improving balance were more robust against detraining, with most positive effects still being present after 8 weeks. However, even with a specific focus on balance, studies started to show some signs of detraining. The current study is limited by the low number of included studies in the review, indicating a need to further confirm these results. Full article
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Review
The Interrelation of Neurological and Psychological Symptoms of COVID-19: Risks and Remedies
J. Clin. Med. 2020, 9(8), 2624; https://doi.org/10.3390/jcm9082624 - 13 Aug 2020
Cited by 3 | Viewed by 2426
Abstract
COVID-19 has catastrophically affected the world’s panoramic view of human well-being in terms of healthcare and management. With the increase in the number of cases worldwide, neurological symptoms and psychological illnesses from COVID-19 have increasingly upsurged. Mental health illness and affective disorders, including [...] Read more.
COVID-19 has catastrophically affected the world’s panoramic view of human well-being in terms of healthcare and management. With the increase in the number of cases worldwide, neurological symptoms and psychological illnesses from COVID-19 have increasingly upsurged. Mental health illness and affective disorders, including depression, obsessive-compulsive disorder, anxiety, phobia, and panic disorders, are highly impacted due to social distress. The COVID-19 pandemic not only affected people with pre-existing mental and affective illnesses, but also healthy individuals with anxiety, worrying, and panic symptoms, and fear conditioning. In addditon, the novel coronavirus is known to impact the central nervous system in the brain, resulting in severe and certain long-lasting neurological issues. Owing to the significance of neurological and psychological events, the present perspective has been an attempt to disseminate the impact of COVID-19 on neural injury through inflammation, and its interrelation with psychological symptoms. In this current review, we synthesize the literature to highlight the critical associations between SARS-CoV-2 infection and the nervous system, and mental health illness, and discuss potential mechanisms of neural injury through psycho-neuroimmunity. Full article
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